OVERALL: SUMMARY The Hollings Cancer Center (HCC) at the Medical University of South Carolina (MUSC) seeks renewal of its National Cancer Institute (NCI) designation via the P30 Cancer Center Support Grant (CCSG) mechanism. As South Carolina's (SC) leading academic medical center, MUSC is charged with building basic, translational, clinical, and population-based research programs that address the state's significant healthcare needs. The mission of the HCC is to reduce the cancer burden in SC through transformative research, patient care, prevention, and public policy. To accomplish this mission, HCC leadership built a robust, multidisciplinary center that includes 107 cancer scientists. Innovative, high-impact research is driven by HCC?s four research programs: Cancer Biology, Cancer Immunology, Developmental Cancer Therapeutics, and Cancer Control. The rapid pace of discovery and movement toward effective translational research is supported by five shared research resources: Lipidomics, Flow Cytometry & Cell Sorting, Cell & Molecular Imaging, Biorepository & Tissue Analysis, and Biostatistics. During the current project period, the HCC successfully leveraged CCSG funding and its NCI-designated cancer center status to harness, expand and improve the center?s research capabilities to decrease the state?s cancer burden. HCC supported recruitment of 26 new cancer scientists. The annual direct peer-reviewed extramural research funding (excluding training and career development awards) increased to $21.6M, with $10.5M from NCI. HCC boasts the state?s largest clinical trials operation that provides centralized support for conducting the most contemporary cancer trials. During the past year, the HCC recruited 1,266 patients to interventional studies and 254 patients to non-interventional studies. HCC made significant progress in overcoming the challenges inherent in recruiting racial and ethnic minorities to participate in research. In 2017, 33% of research participants were racial or ethnic minorities, with more than half residing in rural communities federally designated as medically underserved. This progress has been maintained for over two decades by progressive, HCC-led outreach, community engagement, and cancer education services. With the charge of training the next generation of diverse and exceptional cancer physicians and scientists, the center developed the state?s only comprehensive cancer education pipeline for learners across the entire education continuum, from high school through early professional career development. The HCC is committed to providing access to the latest research, educational, and clinical advances to all of South Carolina, and has never been better equipped to fulfill its mission. Led by a new center director appointed in 2017, the HCC will implement its 2023 strategic plan to advance scientific discovery, make impactful contributions to the understanding of cancer biology in a diverse population, and translate discoveries into transformative approaches to cancer control, diagnosis, treatment, and public policy.